ABSTRACT
Objective: To analyze and compare the effects of different clinical characteristics on the negative conversion time of nucleic acid detection after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection, and to provide a scientific basis for the isolation and treatment of coronavirus disease 2019 (COVID-19). Methods: The epidemiological and clinical data of 228 mild SARS-CoV-2 Omicron variant infected patients diagnosed in Shanghai were retrospectively collected from April 27, 2022 to June 8, 2022 in Wujiaochang designated Hospital, Yangpu District, Shanghai. The negative conversion time of nucleic acid detection was used as the outcome variable, and the patients were divided into A (18 days) and B (>18 days). Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of the negative conversion time of nucleic acid detection. Results: The mean nucleic acid conversion time of 228 patients was (18.7+or-12.1) d, with the median time of 18 (2-46) d. Among them, 120 patients in group A had an average nucleic acid conversion time of (13.2+or-2.0) d, and 108 cases in group B had an average nucleic acid conversion time of (20.8+or-1.3) d. Univariate analysis showed that there were no statistically significant differences in the effects of hypertension, coronary heart disease, diabetes, hypokalemia, malignant tumors, neuropsychiatric diseases, chronic digestive diseases on the negative nucleic acid conversion time (P > 0.05);however, there were significant differences in the effects of combined cerebrovascular disease, leukopenia, chronic respiratory system diseases and vaccination on the negative nucleic acid conversion time (P < 0.05). Further multivariate logistic regression analysis revealed that the combination of chronic respiratory diseases and non-vaccination were significant risk factors for prolongation of negative nucleic acid conversion time (P < 0.05). Conclusions: The results of this study show that gender, age and whether hypertension, coronary heart disease, diabetes mellitus, hypokalemia, malignant tumor, neuropsychiatric disease and chronic digestive disease have no significant effect on the nucleic acid conversion time, whereas chronic respiratory disease and no vaccination are significantly correlated with the prolongation of nucleic acid conversion time in SARS-CoV-2 Omicron-infected patients.
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Since Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) first appeared in China in December 2019, the globe has been dealing with an ever-increasing incidence of COVID-19 (Corona Virus Disease 2019). In addition to respiratory disorders, 40% of patients present with gastrointestinal (GI) involvement. Abdominal pain is the most common indication for computed tomography (CT) and ultrasonography. After GI tract involvement, solid visceral organ infarction is the most prevalent abdominal abnormality in COVID-19. This review aims to gather the available data in the literature about imaging features of solid abdominal organs in patients with COVID-19. Gallbladder wall thickening and distension, cholelithiasis, hyperdense biliary sludge, acalculous cholecystitis, periportal edema, heterogeneous liver enhancement, and liver hypodensity and infarction are among hepatobiliary imaging findings in CT, particularly in patients admitted to ICU. Pancreatic involvement can develop as a result of direct SARS-CoV2 invasion with signs of acute pancreatitis in abdominal CT, such as edema and inflammation of the pancreas. Infarction was the most prevalent renal and splenic involvement in patients with COVID-19 who underwent abdominal CT presenting with areas of parenchymal hypodensity. In conclusion, although solid abdominal organs are rarely affected by COVID-19, clinicians must be familiar with the manifestations since they are associated with the disease severity and poor outcome.
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The spread of SARS-CoV-2 virus among humanity has identified a number of new challenges in the field of medical science. In this regard, it is very important to understand the possible involvement of the liver in the infectious process, as well as the effect of this virus on liver function in its chronic pathology. The article pro-vides an overview of available sources of information regarding views on direct viral liver damage COVID-19, as well as the features of the course and prognosis of this infection in patients with chronic liver disease and cirrhosis. It was emphasized that chronic liver diseases are considered as a high risk factor for COVID-19 infec-tion, and are also predicted to be at an increased risk for the severe course of this infection with the development of complications. Substantial support to patients with chronic liver diseases during the COVID-19 pandemic can be provided by the Fumarta combination drug (Farmak), which includes fumarin alkaloid from the extract of dry herb of the fumaria officinalis and silymarin from the extract of dried fruit of milk thistle. This composition of the drug Fumarta allows normalizing the digestive disorders, which constantly accompany chronic liver disease. In the article, digestive disorders are considered from the point of view of biliary insufficiency, which occurs in virtually every chronic liver disease. Normalization of the formation of bile, its composition with the restoration of rheo-logical properties, improves not only general well-being of a patient, but also positively affects the restoration of the functional capabilities of the liver. The data on the study of each of the active components of the Fumarta drug are presented, which indicates the advisability of its use in this group of diseases. The healing properties of the Fumarta drug are stipulated by the optimal combination of the hepatoprotective effects of silymarin with the normalization of bile secretion and biliary motility by fumarin. The combination of hepatoprotective and choleretic activity complement and enhance the action of each other, which helps to optimize the functioning of the entire digestive system. Patients with liver disease in the context of the COVID-19 pandemic are recommended to take Fumarta drug, the components of which have a versatile positive effect in chronic liver diseases as preventive support. Approaches to pharmacotherapy of chronic liver diseases among the convalescents of COVID-19 are also being considered. In this regard, Fumarta may act as one of the optimal drugs for choosing a rehabilitation course for these patients. © M. B. Shcherbynin, Yu. M. Bondarenko, 2020.
ABSTRACT
Background: WHO has declared Coronavirus 2019 (COVID-19) as pandemic on 11th March 2020. Hydroxychloroquine (HCQ) chemoprophylaxis has been approved by the Indian Council of Medical Research (ICMR) for asymptomatic healthcare workers treating suspected or confirmed COVID-19 cases and asymptomatic household contacts of confirmed patients. However, there is a scarcity of data regarding the efficacy and safety of HCQ for COVID-19 prophylaxis and treatment. Background: The present study was designed to evaluate the adverse drug reaction (ADR) profile of HCQ prophylaxis among healthcare workers in a tertiary care teaching hospital in India. Methods: A Descriptive cross-sectional study was conducted in Kalpana Chawla Medical College and Hospital, Karnal for duration of 3 months (April-June 2020). The study was performed on the reported ADRs due to HCQ prophylaxis by the healthcare workers to the ADR monitoring centre of the institute during this period. Results: Gastrointestinal disturbance such as loose stool (16.4%) and hyperacidity (14.9%) were the most commonly reported ADRs during the study period. The incident rate of adverse drug reactions was 23.7%. The number of ADRs was found to be significantly (p<0.01) more in female as compared to male. We have observed that most of the reactions were reported following the 1st day loading dose. Conclusions: Our results showed that gastrointestinal system was most commonly affected. Loose stool and hyperacidity were most frequently reported ADRs due to HCQ prophylaxis. Larger studies are required to ensure the safety of the use of HCQ as prophylaxis for COVID 19.
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COVID-19 is caused by the SARS-COV-2, which characterized with typical respiratory symptoms. In addition to the respiratory system injury, SARS-COV-2 may also invade other organs that express the cell surface receptor ACE2. Digestive system is a susceptible target of SARS-COV-2. Most patients show clinical symptoms of impaired digestive system during the course of the disease. Gastrointestinal symptoms of COVID-19 include anorexia, nausea, vomiting, diarrhea, abdominal pain, and liver damage. Patients with abnormal symptoms of the digestive system have a greater chance of progressing to severe or critical illness, a worse prognosis, and a higher risk of death. This paper aims to discuss the digestive symptoms of COVID-19 infection, so as to improve the attention to the digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients during clinical diagnosis, treatment and prevention and control.
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Since the appearance of COVID-19 in humans, there have been numerous reports of dogs and cats being infected with SARSCoV- 2, with cats appearing to be particularly susceptible. The portal of entry of the virus into the body's cells is a membrane receptor called ACE2 (angiotensin converting enzyme 2) belonging to the renin-angiotensin-aldosterone system. The ACE2 receptor is expressed in airway epithelial cells, myocardium, venous and arterial endothelial cells, kidney, liver, oral cavity, intestine and also adipose tissue, explaining the diversity of clinical expression of the disease, with respiratory manifestations predominating. SARS-CoV-2 causes an imbalance in the renin-angiotensin- aldosterone system. In addition, the virus has a direct action combined with an immune reaction, that is sometimes intense, causing a cascade of lesions, mainly in the lungs but also in the heart. The clinical expression of SARS-CoV-2 infection remains rare in dogs and cats and mainly includes fever, depression, anorexia, digestive, respiratory or ocular disorders. As in humans, various cardiovascular clinical signs are less frequently seen. Several cases of myocarditis, correlated with a positive SARS-CoV-2 test (PCR or serology), have been identified in England and at least one in France. In the latter case, further investigation led to a strong suspicion of hypertrophic cardiomyopathy complicated by myocarditis. It is highly likely that obesity (with significant fat deposition in the pleural and pericardial spaces, tissues with high expression of the ACE2 receptor) may have favoured these complications. SARS-CoV-2 infection should therefore now be included in the differential diagnosis of agents causing myocarditis and pneumonia in both cats and dogs.
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This proceedings contains the s presented by the participants of the meeting, which summarize experimental and clinical research data on various types of gastrointesinal and liver diseases, including viral hepatitis, non-alcoholic fatty liver, gastrointesinal and hepatic abnormalities in COVID-19 patients.
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Current considerations on nutritional therapy (NT) in the ICU for patients with COVID-19 are based on indirect recommendations established in similar populations of critically ill patients;for example, in conditions such as acute respiratory distress syndrome (ARDS), sepsis, or acute kidney injury. From a practical point of view, it is appropriate that the NT strategy in these patients consider: (1) the phase of the disease, (2) the hemodynamic condition and (3) the type of respiratory support indicated for each individual patient. Therefore, patients with severe pneumonia or COVID-19 sepsis should be considered patients with high nutritional risk. On the other hand, it has been shown that an increased BMI is related to a poor prognosis, which supports a possible role of sarcopenic obesity in the survival of critically ill patients with COVID-19. Patients with sepsis due to COVID-19 and septic shock have no contraindication to start an EN, with the exception of vasopressor doses being increased, presenting elements of tissue dysoxia or acute gastrointestinal dysfunction with intolerance to EN.
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Introduction: Temporary disability due to COVID-19 was expressly regulated, through various rules and instructions, covering both isolation by contact, by infection or for sensitive workers. It involved the integration of preventive labor protection covered by its protection in a financial benefit with the highest amount. Analyzing the consequences of the pandemic in the first wave, confinement, de-escalation and return to normality, months from March to October, the ..collapsing.. impact of COVID-19 on the health system led to the paralysis and increase of waiting lists for tests, operations and non-urgent consultations of the rest of pathologies, and consequently a high increase in the average duration of sick leave for all processes, in confinement and de-escalation in 84.48% and in 25.27% the prolonged casualties that reached more than 365 days. Consequently, COVID-19 as a collateral effect led to a poor evolution of the rest of the processes, prolonging the duration of temporary disabilities, which implies a worsening of occupational health, a greater risk of not returning to work that occurs during sick leave long, higher risk of unemployment, higher spending on benefits and economic decline for companies and the self-employed. Temporary disability due to COVID-19 accounted for 38.73% of all casualties at the end of October 2020. Conclusions: The pandemic forced to prioritize resources around COVID-19, collapsing the care of the rest of pathologies, except for emergencies or vital treatments. This meant an increase in waiting lists for non-urgent consultations, tests or surgical interventions, as well as the cancellation or postponement of consultations or treatments and therefore an increase in the longer duration of sick leave and also the worsening of occupational health, consequently, by not being able to have treatment in a timely manner. In confinement and de-escalation, the average duration of casualties increased by 84.48%;by processes, the increase was 503.58% in respiratory diseases, 215.88%, in infectious diseases, 60.73% in endocrine diseases, 45;42% of blood diseases, 45 09% for digestive diseases, 35.63% for osteomyoarticular disorders, 34.12% for neoplasms, 33.37% for circulatory diseases, 31.94% for ..procedures.., and 29.56% of mental disorders. Long-term sick leave (PIT) that reached 365 days increased by 25.27%, compared to the month of October of the previous year. Prolonged sick leave due to endocrine and nutritional diseases increased by 28.50, from mental disorders by 28.20%, from musculoskeletal disorders by 26.70, from neoplasms by 26.49%, from respiratory diseases in 24.27%, for diseases of the nervous system in 22.79%, for cardiovascular diseases in 20.48%, and for digestive diseases in 19.24%. As a consequence of COVID-19, the working population was exposed to an added and new risk;health and social health workers suffered the disease as a direct consequence of their work due to illness of an undoubted professional nature. The effects of COVID-19 on the delay of tests, surgeries or treatments in ..No COVID-19.. processes and the difficulties of contact with care worsened occupational health, prolonging disability situations and increasing the risk of prolonged non-COVID-19 disabilities, return to work due to the expected poor evolution of any process when it cannot be treated and attended to early.
ABSTRACT
Coronavirus Disease 2019 (COVID-19), although most commonly demonstrates respiratory symptoms, but there is a growing set of evidence reporting its correlation with the digestive tract and faeces. Interestingly, recent studies have shown the association of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection with gastrointestinal symptoms in infected patients but any sign of respiratory issues. Moreover, some studies have also shown that the presence of live SARS-CoV-2 virus in the faeces of patients with COVID-19. Therefore, the pathophysiology of digestive symptoms associated with COVID-19 has raised a critical need for comprehensive investigative efforts. To address this issue we have developed a bioinformatics pipeline involving a system biological framework to identify the effects of SARS-CoV-2 messenger RNA expression on deciphering its association with digestive symptoms in COVID-19 positive patients. Using two RNA-seq datasets derived from COVID-19 positive patients with celiac (CEL), Crohn's (CRO) and ulcerative colitis (ULC) as digestive disorders, we have found a significant overlap between the sets of differentially expressed genes from SARS-CoV-2 exposed tissue and digestive tract disordered tissues, reporting 7, 22 and 13 such overlapping genes, respectively. Moreover, gene set enrichment analysis, comprehensive analyses of protein-protein interaction network, gene regulatory network, protein-chemical agent interaction network revealed some critical association between SARS-CoV-2 infection and the presence of digestive disorders. The infectome, diseasome and comorbidity analyses also discover the influences of the identified signature genes in other risk factors of SARS-CoV-2 infection to human health. We hope the findings from this pathogenetic analysis may reveal important insights in deciphering the complex interplay between COVID-19 and digestive disorders and underpins its significance in therapeutic development strategy to combat against COVID-19 pandemic.
Subject(s)
COVID-19 Drug Treatment , Gastrointestinal Tract/virology , SARS-CoV-2/drug effects , COVID-19/virology , Comorbidity , Computational Biology , Gastrointestinal Tract/pathology , Gene Regulatory Networks/genetics , Humans , Pandemics , Protein Interaction Maps/genetics , SARS-CoV-2/pathogenicity , Systems BiologyABSTRACT
The symptoms associated with COVID-19 are mainly characterized by a triad composed of fever, dry cough and dyspnea. However, digestive symptoms have also been reportedAt first considered as infrequent, they in fact seem to affect more than half of patients. The symptoms are mainly manifested by anorexia, diarrhea, nausea and/or vomiting and abdominal pain. Even though prognosis is associated with lung injury, digestive symptoms seem significantly more frequent in patients presenting with severe COVID-19 infection. Digestive forms, which may be isolated or which can precede pulmonary symptoms, have indeed been reported, with diarrhea as a leading clinical sign. The main biological abnormalities that can suggest COVID-19 infection at an early stage are lymphopenia, elevated CRP and heightened ASAT transaminases. Thoraco-abdominal scan seems useful as a means of on the one hand ruling out digestive pathology unrelated to coronavirus and on the other hand searching for pulmonary images suggestive of COVID-19 infection. No data exist on the interest of digestive endoscopy in cases of persistent digestive symptoms. Moreover, the endoscopists may themselves be at significant risk of contamination. Fecal-oral transmission of the infection is possible, especially insofar as viral shedding in stools seems frequent and of longer duration than at the ENT level, including in patients with negative throat swab and without digestive symptoms. In some doubtful cases, virologic assessment of stool samples can yield definitive diagnosis. In the event of prolonged viral shedding in stools, a patient's persistent contagiousness is conceivable but not conclusively established. Upcoming serology should enable identification of the patients having been infected by the COVID-19 epidemic, particularly among previously undetected pauci-symptomatic members of a health care staff. Resumption of medico-surgical activity should be guided by dedicated strategy preceding deconfinement.